| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,680 |
2,373 |
$76K |
| 92250 |
|
2,295 |
2,022 |
$72K |
| 92081 |
|
2,399 |
2,123 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,034 |
898 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
547 |
504 |
$31K |
| V2020 |
Frames, purchases |
1,090 |
1,025 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
792 |
743 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
527 |
283 |
$9K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
428 |
200 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
101 |
71 |
$2K |
| 92225 |
|
28 |
12 |
$222.84 |
| V2760 |
Scratch resistant coating, per lens |
780 |
373 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
36 |
16 |
$0.00 |
| 92201 |
|
28 |
15 |
$0.00 |